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Winter Sports Health Tips |
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Proper ski boot fit
For ski boots movement inside the boot can contribute to problems. Movement can occur if the boots are too big, do not fit properly or the liner inside the boot has 'packed out'. Movement of the foot inside the boot can compromise the foot-to-ski control. The foot can move inside the boot in a variety of ways. Some examples are heel movement upwards, pistoning inside the boot or side to side torque on the middle of the foot.
To determine if your boot is the right fit:
- Remove the liner and put your foot inside the boot and slide the foot forward until the toes touch the front end of the boot shell.
- Measure the distance between the heel and the back shell of the boot near your achilles tendon with your foot still slid forward and toes touching the front end of the shell. There should be only a finger to a finger and half distance between the heel and the boot shell near your Achilles tendon.
- If there is more room than that the boot is too big.
Properly Buckling the boot
If your ski boot is a traditional buckle and not rear entry this is a way to ensure that your foot fits properly in the boot. Buckle your top two buckles first. Doing so pulls the foot back and seats the foot into the heel pocket of the boot. The ski boot should feel snug when buckled loosely. If you have to crank the buckles for a tight fit, your boot might be too big. You should no pain or pressure points while wearing the boot. If so see a qualified boot fitter.
Avoiding snowboarding injuries
Snowboarding is a sport that can place tremendous strain on the feet. The foot and ankle are under more stress than with skiing. The foot and ankle are allowed much more movement because of the type of boots. Snowboarders should stretch their calf muscle and toe joints prior to riding. The toe joints can be flexed into positions that are far more than what occurs with walking. Avoid boots that are too loose that allow the foot to 'piston'. This can contribute to blisters on the heel and injuries to the toes and toenails. Prior to and after riding snowboarders should also stretch their glutei muscles (rear end muscles), hamstrings and quadriceps. The back leg of a snowboarder undergoes intense repetitive muscle contraction of many muscles of the lower extremity at the same time. Rest when your legs are tired, this helps avoid muscle pulls and painful falls. And last but not least WEAR A HELMET !
Each Winter , I see at least one patient suffer a frostbite injury to their toes or feet. Usually they present to the office uncertain that they have suffered frostbite. Most recently a gentleman presented to the office complaining of a persistent rash to the tips of his toes. Unfortunately this was a first degree frostbite injury. Our local emergency room physicians and paramedics often see much more every Winter.
Imagine you are eleading a winter snowshoeing group in the high country and the weather turns for the worse, the group is forced to be out much longer than expected. Unprepared, one participant suffers a cold injury to his toes. He shows you his feet under shelter and the toes have very pale white skin. On some the toes you see a few deep purple blisters with surrounding redness. Two other snowshoers complain of numb white patches on their exposed faces. Your immediate concern is for frostbite. The person with the injured toes has suffered third degree frostbite and needs proper and immediate medical attention. The two people with the numb discolored patches on their faces have suffered first degree frostbite. It is best to warm first degree frostbite as fast as possible seeking shelter from the cold and wind. Placing the exposed area inside a warm coat or on another's stomach can help. When body parts such as hands are affected placing them in an armpit or inside ones pants can be very helpful. You can also exchange gloves with a friend. Get out of the exposed cold and wind as quickly as possible, especially if the face is affected. Cover the affected person with warm clothing.
The affected areas should never be rubbed, especially with ice or snow. For deep frostbite it is best to re-warm the area rapidly in water 104-108 degrees F, but only if the part can stay warm. Frostbite and thermal injuries can happen quickly and cause permanent damage to tissue. When being active this Winter be prepared and use common sense. If you think you have suffered frostbite seek the proper medical attention sooner than later.
Another injury that is becoming more common is "snow-boarders" ankle. This injury usually feels and looks like a sprained ankle. Usually this is suffered when a boarder lands improperly after being in the air. This injury is actually a fracture of the lateral process of the talus. The talus is one of three bones that make up the ankle joint. Pain is located on the outside and back of the ankle and bruising is usually present. The amount of pain can be similar to a bad sprain. This injury can also happen in snowshoeing when a jump thought the air is done. Be careful when you are doing these sports to avoid this injury and seek medical attention when suspicious of a more serious injury. Lastly, many skiers squeeze their feet into improperly fitted ski boots and encounter blood that has accumulated underneath the bit toe nail. This injury appears benign but should not be ignored. The medical term for it is "subungual hematoma". If the blood under the nail has not consolidated and is still in a fluid form then it is best to have it drained by a medical professional. The presence of fresh blood may indicate an injury to the tissue under the nail (nail bed) which can lead to a bacterial infection of the toe. if the blood has dried then leave it alone and monitor it. Your toenail may fall off in several week and a new one will grown in, but it may take up to a year for the nail to be replaced. During this time it is advised to apply a prescription strength topical antifungal on the toe daily to help prevent nail fungus from developing.
HAVE FUN AND BE SAFE IN THE OUTDOORS THIS WINTER ! |
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